<!--
  ========================LICENSE_START=================================
  screenit-web
  %%
  Copyright (C) 2012 - 2020 Facilitaire Samenwerking Bevolkingsonderzoek
  %%
  This program is free software: you can redistribute it and/or modify
  it under the terms of the GNU Affero General Public License as published by
  the Free Software Foundation, either version 3 of the License, or
  (at your option) any later version.
  
  This program is distributed in the hope that it will be useful,
  but WITHOUT ANY WARRANTY; without even the implied warranty of
  MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.  See the
  GNU General Public License for more details.
  
  You should have received a copy of the GNU Affero General Public License
  along with this program.  If not, see <http://www.gnu.org/licenses/>.
  =========================LICENSE_END==================================
  -->
<html xmlns:wicket="http://wicket.apache.org">
<wicket:extend>
    <div class="row-fluid">
        <div class="span12">
            <h1 class="pageTitle">
                Specifieke gegevens
            </h1>
        </div>
    </div>
    <div class="row-fluid form-horizontal">
        <fieldset>

            <wicket:container wicket:id="paspoort"></wicket:container>

            <form wicket:id="form">

                <wicket:container wicket:id="parent"></wicket:container>
                <wicket:container wicket:id="regio"></wicket:container>
                <wicket:container wicket:id="paLabs"></wicket:container>

                <fieldset>
                    <div class="row-fluid">
                        <div class="span12">
                            <legend>Fully Qualified Domain Name</legend>
                        </div>
                    </div>
                    <div class="row-fluid">
                        <div class="span6">
                            <div class="control-group">
                                <label class="control-label" for="fqdn">FQDN</label>
                                <div class="controls">
                                    <input wicket:id="fqdn" id="fqdn" class="input-large" type="text" value="30">
                                </div>
                            </div>
                        </div>
                    </div>
                </fieldset>

                <div class="row-fluid">
                    <div class="span12">
                        <div class="form-actions btn-bottom">
                            <button wicket:id="annuleren" class="btn">Annuleren</button>
                            <button wicket:id="submit" class="btn btn-primary">Opslaan</button>
                        </div>
                    </div>
                </div>
            </form>
        </fieldset>
    </div>
</wicket:extend>
</html>
